Author: Bursi, Francesca; Santangelo, Gloria; Sansalone, Dario; Valli, Federica; Vella, Anna Maria; Toriello, Filippo; Barbieri, Andrea; Carugo, Stefano
Title: Prognostic utility of quantitative offline 2Dâ€echocardiography in hospitalized patients with COVIDâ€19 disease Cord-id: bcynpexm Document date: 2020_9_22
ID: bcynpexm
Snippet: PURPOSE: To assess the prognostic utility of quantitative 2Dâ€echocardiography, including strain, in patients with COVIDâ€19 disease. METHODS: COVIDâ€19â€infected patients admitted to the San Paolo University Hospital of Milan that underwent a clinically indicated echocardiographic examination were included in the study. To limit contamination, all measurements were performed offline. Quantitative measurements were obtained by an operator blinded to the clinical data. RESULTS: Among the 49 p
Document: PURPOSE: To assess the prognostic utility of quantitative 2Dâ€echocardiography, including strain, in patients with COVIDâ€19 disease. METHODS: COVIDâ€19â€infected patients admitted to the San Paolo University Hospital of Milan that underwent a clinically indicated echocardiographic examination were included in the study. To limit contamination, all measurements were performed offline. Quantitative measurements were obtained by an operator blinded to the clinical data. RESULTS: Among the 49 patients, nonsurvivors (33%) had worse respiratory parameters, index of multiorgan failure, and worse markers of lung involvement. Right ventricular (RV) dysfunction (as assessed by conventional and 2â€dimensional speckle tracking) was a common finding and a powerful independent predictor of mortality. At the ROC curve analyses, RV free wall longitudinal strain (LS) showed an AUC 0.77 ± 0.08 in predicting death, P = .008, and global RV LS (RVâ€GLS) showed an AUC 0.79 ± 0.04, P = .004. This association remained significant after correction for age (OR = 1.16, 95%CI 1.01–1.34, P = .029 for RV free wall LS and OR = 1.20, 95%CI 1.01–1.42, P = .033 for RVâ€GLS), for oxygen partial pressure at arterial gas analysis/fraction of inspired oxygen (OR = 1.28, 95%CI 1.04–1.57, P = .021 for RV free wallâ€LS and OR = 1.30, 95%CI 1.04–1.62, P = .020 for RVâ€GLS) and for the severity of pulmonary involvement measured by a computed tomography lung score (OR = 1.27, 95%CI 1.02–1.19, P = .034 for RV free wall LS and OR = 1.30, 95%CI 1.04–1.63, P = .022 for RVâ€GLS). CONCLUSIONS: In patients hospitalized with COVIDâ€19, offline quantitative 2Dâ€echocardiographic assessment of cardiac function is feasible. Parameters of RV function are frequently abnormal and have an independent prognostic value over markers of lung involvement.
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